DYSLEXIA – Types, Clinical features and Management

As the most common learning disorder, accounting for around 80% of cases, dyslexia is a specific form of learning disorder. With 17.5 to 21% of cases, it is also the most prevalent neurobehavioral disorder among children.

Notably low performance and reading difficulties are its hallmarks, while the kids' IQs are either normal or high.  It frequently remains undiagnosed or manifests symptoms later than expected.  Gender prediction is absent from the illness, which affects both men and women equally.  Attention deficit hyperactivity disorder is the most prevalent comorbidity of dyslexia (ADHD). 

Types Of Dyslexia

As the youngster advances in school, a gap between reading proficiency and IQ is shown. Plots of reading proficiency and IQ against school grades for a typical child run parallel. The reading skill graph for a dyslexic youngster deviates from IQ.

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Meaning Of Dyslexia

Dyslexia is defined in two ways: Under the federal or legal definition
It is an unexpected challenge for a bright person to read more fluently. This is typically brought on by phonological processing deficiencies, which impede a person's ability to talk, read, and spell (the recognition of specific sounds in spoken language). 

A standard or clinical definition

It is an unanticipated inaccuracy or fluency of reading given a person's age, IQ, educational attainment, or occupation. 

The Dyslexia Etiopathogenesis

Genetic inheritance from parents is the main cause.  According to clinicians, the 50% rule for dyslexia inheritance is as follows: o A dyslexic person's parents must also be dyslexic.  A dyslexic person's siblings are impacted in 50% of cases. 

There is a 50% chance that a child of a dyslexic may inherit dyslexia.
Several genes have been linked to dyslexia through genome-wide association studies, however each gene's specific contribution to the disorder varies.

Dyslexia Phonological Theory

While reading comprehension is a learned skill, speaking is a natural capacity for every person. The phonological process—which is disturbed in dyslexic people—is linked to speaking and reading proficiency.

Phonemes are perceptually separate units of sound in a language that serve as word separators. The capacity to match letters and words to their corresponding phonemes is a prerequisite for reading proficiency. Phonological processes are the neurological mechanisms underlying the function. 

Neural Dyslexia Signature

Functional MRI pictures reveal a deficiency in the posterior left hemisphere's center functioning. Furthermore, they exhibit hyperactivity in the Broca's region when producing speech. However, as the understanding of neural signature is a general conclusion derived from studies involving several participants, fMRI is not a recommended method of diagnosing specific dyslexia cases. 

Traditional Aspects Of Dyslexia

The main language difficulties that dyslexic people have are with spoken and written language.  Spoken language abnormalities include irregular pauses, mispronunciations, lack of fluency, difficulty finding the right words, and slow reaction times to questions. 

In normal people, it is not appropriate to mistakenly label dyslexia for sporadic speech issues caused by psychological reasons like stress or stage fear. Dyslexics read very slowly and often self-correct. The ability to listen is unaffected; accuracy increases with time and therapy, but reading speed does not.

The clinical characteristics listed below should raise the possibility of dyslexia

• Excessive mispronunciations.
• Reading too slowly, which results in a decline in fluency; • Written tests take a long time to complete.
• A low score on multiple-choice questions because it was hard to tell apart the closely related words in the available selections.
• The introduction of new phonemes is the cause of the difficulty in learning a second language.
• Have a deeper understanding than they can convey.

Determination of dyslexia

• Despite our limited understanding of neural markers and genetic origins, clinical findings are a good basis for diagnosing dyslexia. Here are a few tests that are frequently used. 
• CTOPP-2, the Comprehensive Test of Phonological Processing
  The third edition of the Wechsler Individual Achievement Test, or WIAT-3, is a letter-word subtest. 
• The Nelson-Denny reading exam and other timed reading assessments are reliable across all age groups. The exam of Word Reading Efficiency (TOWRE). 

How To Manage Dyslexia

• Modified accommodations and early remediation are part of the management plan.
• Early remediation of reading difficulties consists of the following five elements. Teaching a youngster to manipulate and associate phonemes, starting with simple ones and one or two at a time, is known as phonological awareness. 
• Phonics: Teaching the youngster to link letters and words to their appropriate sounds. 
• Fluency: aiding the young learner's speaking. 
• Vocabulary development: This entails giving the youngster a wider vocabulary by calling various items by different names on a regular basis. 
• Understanding strategies: neurologists are needed to help.

Accommodation

This entails placing dyslexic students in educational institutions and initiatives that design coursework to accommodate their needs, including extra language instruction and longer exam periods.

Dyslexia does not imply a lack of intelligence. However, it is a reading disability. Children with dyslexia benefit more from early remediation than do children with fluency in speech, reading, and writing. 

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Hope you found this blog helpful for your Growth and Development NEET SS pediatrics preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.